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Factors associated with prolonged mechanical ventilation in the burn patient
Sofía Kohn1, Alejandra Stolovas1, Florencia Urrestarazu1
1National Burn Centre (CENAQUE), "Dr. Manuel Quintela" University Hospital, University of the Republic, Uruguay. Av. Italia s/n, piso 13, Montevideo, Uruguay.
Burns : Journal of the International Society for Burn Injuries
|December 11, 2025
Summary
Short-term mechanical ventilation (STMV) is common in burn patients and may be unnecessary. Prolonged mechanical ventilation (PMV) is linked to higher burn severity, age, facial burns, and shock.
Area of Science:
- Burn Care
- Critical Care Medicine
- Respiratory Therapy
Background:
- Evaluating the incidence of short-term mechanical ventilation (STMV) in burn patients.
- Identifying clinical findings (CF) associated with prolonged mechanical ventilation (PMV).
Purpose of the Study:
- To determine the frequency of STMV in burn patients.
- To identify clinical factors predicting the need for PMV.
Main Methods:
- Retrospective review of 973 adult burn patients requiring endotracheal intubation (EI) from 2010-2023.
- Categorization into STMV (≤2 days) and PMV (>2 days) groups.
- Multivariable logistic regression to identify predictors of PMV and calculate diagnostic performance metrics (SE, SP, PPV, NPV).
Main Results:
- STMV incidence was 42.3%.
- PMV was associated with increased total body surface area burn (TBSA), age, full-thickness facial burn (FTFB), and shock.
- Shock and FTFB demonstrated high specificity and positive predictive value for PMV, with moderate negative predictive value in patients with TBSA < 20%.
Conclusions:
- STMV may be overused in burn patients, suggesting a need for revised airway management protocols.
- FTFB and shock are key indicators for predicting PMV.
- Further research and protocol development are recommended for optimizing mechanical ventilation in burn care.
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